Journal of Gastrointestinal Cancer

, Volume 50, Issue 4, pp 983–990 | Cite as

A Modified Low-Cost Technique of Cytoreductive Surgery (CRS) and Hyperthermic Intraperitoneal Chemotherapy (HIPEC) in Two Patients: a Solution for Pseudomyxoma Peritonei in the Indian Scenario?

  • Anil Kumar Singh Rana
  • Nitin AgarwalEmail author
  • Sushant Dutta
  • Manoj Kumar Dokania
  • Himank Goyal
Case Report


Cytoreductive surgery (CRS) and hyperthermic intraperitoneal chemotherapy (HIPEC) have emerged as feasible treatment modalities for peritoneal dissemination (pseudomyxoma peritonei—PMP) in selected malignancies of the ovaries, appendix, colorectum, stomach, and even urinary bladder [1, 2, 3]. The time period after 2010 has seen a noticeable boost in the number of centers adopting this technique [3]. It has been shown that removing all macroscopic tumor tissue from the peritoneal surface (residual < 2.5 mm) facilitates destruction of the residual cells by local chemotherapy, heated to 40–45 °C for maximum penetration. This approach has shown better survival and less complication rates than systemic chemotherapy administered pre-or postoperatively in the same subset of patients. Better results have been demonstrated in certain pathological subtypes of PMP like metastatic colorectal carcinoma and disseminated peritoneal adenomucinosis (DPAM) [4, 5].

Since the procedure is...



Hyperthermic intraperitoneal chemotherapy


Cytoreductive surgery


Peritoneal cancer index


Completeness of cytoreduction


Disseminated peritoneal adenomucinosis


Pseudomyxoma peritonei


Authors’ Contributions

Rana AKS: idea, clinical contribution, editing

Agarwal N: idea, clinical contribution, writing of manuscript, and editing

Dutta S: writing of manuscript and editing

Dokania MK: writing of manuscript and editing

Goyal H: writing of manuscript and editing.

Compliance with Ethical Standards

Ethics Approval and Consent to Participate

Informed consent was taken from the patient; the study is case report which conforms to the standards of the institutional ethics committee.

Consent for Publication

Informed consent was taken from the patient.

Availability of Data and Material

Not applicable.

Conflict of Interest

The authors declare that they have no conflict of interest.


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Copyright information

© Springer Science+Business Media, LLC, part of Springer Nature 2018

Authors and Affiliations

  1. 1.Department of Surgery, Renal Transplant UnitPostgraduate Institute of Medical Education and Research (PGIMER) and Dr. Ram Manohar Lohia Hospital (RMLH)DelhiIndia

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